In the field of orthopedic hip prostheses, it is known to produce acetabular prostheses consisting of an insert with a semispherical cavity which acts as a positioning and rotation seating for the head of the femoral prosthesis.
The insert, in its turn, is normally disposed inside a mating shell, or acetabular cup, with an internal cavity, made of osteo-compatible metal material, for example with a titanium base or a cobalt base, attached in an acetabular seating of the hip.
In this context, resurfacing prostheses are known, suitable to be attached on the head of the femur, leaving it substantially intact.
Resurfacing systems have been used for many years in reconstruction surgery of the hip with the purpose of:                preserving the neck and a portion of the head of the femur in active, young patients;        using diameters of the head which are nearer to the anatomical diameter, compared with traditional implants, in order to restore the articular biomechanics and at the same time to guarantee a smaller risk of dislocation;        facilitating possible future revisions with a traditional implant, since the proximal part of the femur is intact, instead of with revision implants.        
The resurfacing systems on the market traditionally provide couplings of the metal-metal type.
Recently, some resurfacing systems have shown a higher failure rate than that of traditional implants. More generally, a possible drawback has emerged in the case of metal-metal couplings, due to the release of metal ions, which have developed following wear on the components in the human body. These ions have different side effects including deterioration in the tissues surrounding the implant, loss of the implant itself and in some cases effects at a systemic level (heart, nervous system, etc. . . . ). The development of these wear phenomena is more evident in cases where the acetabular implant is not perfectly positioned in terms of inclination and turning. Consequently, even though, by using metal-metal couplings, very limited thicknesses are obtained which adapt well to the production of resurfacing prostheses, it is better to avoid this type of coupling because of the drawbacks described above.
From the document DE-A-19616059 it is known to make a prosthesis which has a cylindrical coupling, in particular, which provides the possibility of an insert with a diameter larger than that of the cup. This technique is usually used in cylindrical forced couplings in mechanics. More specifically, the coupling provided achieves a congruency between the two spherical surfaces, in order to have a better distribution of the contact.
Document DE-A-19701536 describes an articulation prosthesis of the known type, which provides a conical coupling of inserts made of ceramic, but without providing a mechanical forcing in proximity to the coupling plane between acetabular cup and insert defined along the coupling axis.
Document EP-A-1.712.206 describes an acetabular prosthesis which provides a conical coupling similar to DE-A-19701536.
Document WO-A-2004/017870 describes an expandable cotyloid cavity, or acetabular cup, which is made elastic by means of radial sections and which provides a throat inside which a flange or tooth of the insert is coupled in snap-in manner, in order to prevent it from coming out. In substance, the coupling occurs by connecting the tooth into the throat and subsequent conical coupling.
Document WO-A-2006/125711 describes a prosthesis provided with recesses made only directly under the surface, which connect with the outside through transverse apertures.
Document US-A-2012/095569 describes a prosthetic joint which comprises a contact member made of metal or ceramic with an osteo-integrating resurfacing surface, such as trabecular metal, texturized metal, sintered or extruded integration textures, which is made only on the surface, not wholly throughout the component without a break in continuity.
One purpose of the present invention is therefore to produce an acetabular prosthesis which on the one hand can be made with reduced thicknesses and on the other hand is compatible and has good mechanical resistance, in particular to wear, and thus prevents the release of ions.
Another purpose of the present invention is to produce an acetabular prosthesis of a total prosthesis of the hip which can be configured as a resurfacing prosthesis, thus obtaining the typical advantages of this type of prosthesis, but without the drawbacks of the metal-metal coupling described above.
Another purpose of the present invention is to produce an acetabular prosthesis of a total prosthesis of the hip, the insert of which, once disposed inside the acetabular cup or shell, maintains, during normal use, the position determined during the operation of inserting the acetabular cup inside the acetabular seating and of the prosthesis of the femoral head, inside the insert, preventing rotation with respect to the common axis of symmetry.
Another purpose of the present invention is to perfect a production method which optimizes the assembly and installation of the acetabular prosthesis.
The Applicant has devised, tested and embodied the present invention to overcome the shortcomings of the state of the art and to obtain these and other purposes and advantages.